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Copii / adolescenți cu tulburare de spectru autist (TSA)

Autismul - ce este?

Autismul are multe descrieri È™i mulÈ›i părinÈ›i îÈ™i pot vedea sau nu copiii în unele dintre ele. Însă diagnosticarea autismului se face conform unor criterii complexe È™i numai dacă copilul îndeplineÈ™te multe dintre aspectele care cuprind aceste definiÈ›ii:

 

A. Deficite persistente în comunicarea socială È™i interacÈ›iunea socială în contexte multiple, manifestate prin următoarele, în prezent sau în trecut:

  1. Deficite în reciprocitatea socio-emoÈ›ională, variind, de exemplu, de la o abordare socială anormală È™i eÈ™ecul conversaÈ›iilor normale de tip „tu spui, eu spun”; până la o partajare redusă a intereselor, emoÈ›iilor sau afectului; până la incapacitatea de a iniÈ›ia sau de a răspunde la interacÈ›iuni sociale.

  2. Deficite în comportamentele comunicative nonverbale utilizate pentru interacÈ›iunea socială, variind, de exemplu, de la o comunicare verbală È™i nonverbală slab integrată; la anomalii în contactul vizual È™i limbajul corpului sau deficite în înÈ›elegerea È™i utilizarea gesturilor; până la o lipsă totală de expresii faciale È™i comunicare nonverbală.

  3. Deficite în dezvoltarea, menÈ›inerea È™i înÈ›elegerea relaÈ›iilor, variind, de exemplu, de la dificultăți de adaptare a comportamentului la diverse contexte sociale; la dificultăți în împărtășirea jocurilor imaginative sau în a-È™i face prieteni; până la lipsa de interes față de colegi.

 

B. Modele restrictive, repetitive de comportament, interese sau activități, manifestate prin cel puÈ›in două dintre următoarele, în prezent sau în istoric:

  1. MiÈ™cări stereotipe, utilizarea repetitivă a obiectelor sau a anumitor cuvinte sau expresii verbale (de exemplu,  alinierea jucăriilor sau răsturnarea obiectelor, ecolalie, fraze speifice).

  2. Insistență asupra monotoniei, aderență inflexibilă la rutine sau tipare ritualizate ori comportament nonverbal (de exemplu, suferință extremă la schimbări mici, dificultăți la tranziÈ›ii, tipare rigide de gândire, ritualuri de salut, nevoia de a merge pe acelaÈ™i traseu sau de a mânca aceaÈ™i mâncare în fiecare zi).

  3. Interese fixe, extrem de restrânse, anormale ca intensitate sau focalizare (de exemplu, ataÈ™ament puternic sau preocupare pentru obiecte neobiÈ™nuite, interes perseverant).

  4. Hiper- sau hipo-reactivitate la stimuli senzoriali sau interese neobișnuite pentru aspectele senzoriale ale mediului (de exemplu, indiferență aparentă față de durere/temperatură, reacție adversă la sunete sau texturi specifice, miros sau atingere excesivă a obiectelor, fascinație vizuală pentru lumini sau mișcare)

C. Simptomele trebuie să fie prezente în perioada de dezvoltare incipientă (dar este posibil să nu se manifeste pe deplin până când cerinÈ›ele sociale nu depășesc capacitățile limitate sau pot fi mascate de strategii învățate mai târziu în viață).

D. Simptomele cauzează afectare semnificativă clinic în domeniile social, ocupaÈ›ional sau în alte domenii importante ale funcÈ›ionării curente.

(Sursa: https://www.autismspeaks.org/autism-diagnostic-criteria-dsm-5)

 

PărinÈ›ii simt adesea că ceva ar putea fi foarte diferit cu copilul lor - această conÈ™tientizare poate apărea din compararea copilului lor cu ceilalÈ›i, dintr-un sentiment intuitiv sau din înÈ›elegerea etapelor tipice de dezvoltare pe care un copil ar trebui să le atingă.

Ce lipsește - ce poate fi dezvoltat

Humans naturally focus on the eyes and faces of others because they provide rich information. From an early age, a child’s brain directs their attention to their parents’ faces. Through repeated exposure, children gradually learn to interpret what they see and begin to assign meaning to facial expressions - they start to attribute meaning. This complex ability starts developing as early as one year old.

Looking at faces to gather information remains a pivotal behavior throughout life. As children grow and explore their environment, they often check an adult’s face to understand whether they are being approved or corrected. The ability to decode facial expressions is a foundational skill that helps children learn about their surroundings and prepares them to understand more subtle social signals, like body language, later on.

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Another important skill that develops from paying close attention to the faces of parents and caregivers is imitation. We start with language imitation—children notice that people around them are making sounds, and they naturally want to try doing the same. One key part of becoming aware of ourselves is that we first develop as attentive listeners before we begin to reproduce what we see and hear.

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As listeners, children start by hearing others, then gradually begin to hear their own voices. This is how language learning begins—listening to others, listening to ourselves, and then listening to ourselves as we repeat sounds. When children imitate speech, they move their tongues and produce sounds, discovering they enjoy the sensations in their mouths. At the same time, they notice how happy their parents are when they make these sounds, which encourages them to keep trying.

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Even as we become fluent speakers over the years, we often don’t realize that we still ‘listen’ to the voice inside our heads—an almost instantaneous, internal process. When children first start speaking, their speech is loud and external. With practice, language becomes more internal and subtle, and we learn when to speak out loud and when to keep our thoughts to ourselves.

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I often meet people (myself included) who thought they had communicated something clearly, but in reality, they were just talking to themselves and never truly shared the information with others. This shows how complex and fascinating the process of communication really is.

 

But children don’t just focus on faces—they also begin to notice the body, especially movements of the hands and limbs. They see their parents using their hands in meaningful ways and naturally wonder, “If they can move their hands like that, why can’t I try too?” Over time, children become more aware of different body parts and develop the desire to imitate what they observe.

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This process is supported by the encouraging responses from their parents. Having already learned to read facial expressions, children start to understand these positive reactions as reinforcements, which motivates them to keep practicing and exploring new movements.

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Our behaviors gradually become more complex, interconnected, and often occur simultaneously.

 

But what happens when a child does not go through these natural, repetitive steps of looking at their parents’ faces? Many important milestones—such as decoding facial expressions and learning how to interact with the environment—may be missed. Language imitation might be limited or absent altogether. It is possible that the brain has not fully developed the connections with the nervous system and sensory receptors, so the child does not feel the sensations in their mouth that usually encourage them to repeat sounds because they enjoy them.

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Additionally, the child might struggle to hear their own voice internally—they may not “listen” to themselves in the way most children do. They might observe the movements of others’ bodies and hands but not understand that they are meant to imitate those gestures. This lack of connection can make early communication and social learning much more challenging.​​​

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